Endo

Question 1

Pituitary insufficiency presents in what order of hormones?

Answer 1

‘Go Look For The Adenoma Please’

GH, LH, FSH, TSH, ACTH, PRL+Post pit (oxy +ADH)

Question 2

Causes of hypopituitarism

Answer 2

8 x Is
- Infection - syph, fungal, etc
- Invasive - tumours: primary adenomas, cranipharyngoma, custs (rathke’s cleft), mets
- Infarction/haemorrhage: Sheehan’s infarction due to post-partum blood lose and hypovoluemia; pituitary apoplexy - acute haemmorrhage - can be fatal
Infiltrate/Inflam - sarcoidosis, haemochrom, histiocytosis
Injury - severe head injury
- iatrogen: radiation / surg
Idiopathic: familial

Question 3

Test for no pituitary fxn? Triple bolus test

Answer 3

Rapid IV infusion of insulin, GnRH and TRH then test:

• for hypoglycaemia induced inc in GH and ACTH
• for increased LH & FSH
• for increased TSH and PRL

Question 4

Presentation of SIADH

Answer 4

Hypokalemia, dilutional hyponatraemia, very dilute osmolality of serum with conc urine

Question 5

Presentation of diabetes insipidus

Answer 5

polyuria, polydipsia, thirst.

Will have hypokalemia and hypernatramia and low urine conc